Why Alberta's COVID-19 numbers might be so high compared to elsewhere

Alberta has reported a higher number of cases of COVID-19 by population for much of the pandemic compared to the rest of Canada. 

They're currently neck and neck with Quebec's and remain stubbornly high compared to neighbouring provinces, even though they never reached the levels laid out in the government's worst-case scenarios and are well below the springtime peak. 

Currently, Alberta — with a population of about 4.4 million — has more active cases than Ontario, with a population of 14.6 million.

Why?

Is there something in Alberta's culture or politics that could be driving the higher numbers? Is there some demographic clue that explains it all? Is it policy? A few different factors might be behind it.

The epidemiology

According to data reported on Aug. 12, Alberta had nearly 24 active cases per 100,000 residents, compared to 21 for Quebec and six for Ontario — two provinces that have often led the country in total cases — and 13 next door in Saskatchewan. 

This is still a big improvement from May, when Alberta peaked at just over 70 active cases per 100,000, but it's well above the low of eight per 100,000 in June. Quebec, by comparison, peaked at just over 350. 

Craig Jenne, an infectious disease expert at the University of Calgary, says age is likely one of the reasons Alberta is seeing more cases since the province eased restrictions. 

"We in general have a lower average age here, which means there are more people, for example, working jobs that may expose them," he said.

"But also more people that are likely going out to restaurants and pubs and bars than other provinces."

Statistics Canada estimates the median age in Alberta in 2019 is 37.1 — the lowest of the provinces, but higher than Nunavut and the Northwest Territories. 

It's below the national median of 40.8 and well below some of the provinces with the oldest populations, like Newfoundland and Labrador at 47.1.

Outbreaks have been attributed to bars and restaurants in Alberta, including 58 cases linked to the Fire N Ice Lounge in Calgary, 23 to the Cactus Club on Stephen Avenue in Calgary, as well as 19 to Greta Bar and 12 to The Pint, both in Edmonton.

Jenne also notes that there appears to be a shift in attitudes across North America and Europe. 

"We're seeing that shift strongly as cases move from older to younger people — this attitude that they are protected, or that at least it's not a dangerous infection," he said.  

"And as a result, people are willing to take more risk, and that does lead to increased infections."

Alberta's higher numbers can't simply be brushed off by attributing them to higher per capita testing for COVID-19 than every other province except Ontario.

Jenne points to the hospitalization rates in Alberta, which are currently second only to Quebec, and also a high rate of positive results in relation to tests administered.

Alberta was ahead of most of Canada in reopening its economy starting in May, which could also be a factor, Jenne said. He predicted other jurisdictions could see their numbers rise in the coming weeks.

"Now, the good news is it seems to be stabilizing, and we can hold at this level fairly safely," said Jenne. 

The Albertan attitude

Alberta is often viewed, inside and outside the province, as some sort of cohesive political monolith focused on libertarian values. Like most stereotypes, that one's not quite up to snuff. 

"So to say, well, Alberta numbers are going up because there's something sort of attitudinally odd about Alberta, that doesn't really explain kind of the regional differences we're seeing now," said Janet Brown, an Alberta-based pollster who frequently mines the views of the province's residents. 

"If it was, if it was all about these libertarians who were just too damn stubborn to wear masks, then … we should have seen outbreaks in rural Alberta a long time ago."

Instead, Brown notes the pandemic was largely a story of Calgary and area until recently. The biggest outbreaks over the course of the pandemic have been among largely immigrant communities that work in meat plants just south of Calgary.

Some of Brown's past polling, commissioned by the CBC, shows Albertans are politically drawn to the middle of the road rather than the left and right fringes. 

Brown says the province is far more diverse in its views than most of the rest of Canada realizes and that makes it difficult to isolate easy answers regarding some social driver of the higher COVID-19 numbers. 

But there are ideological factors at play for how Albertans have responded to the pandemic. 

Brown says the most distinct split in attitudes regarding COVID-19 she found in recent polling for CBC News was between left and right — with those on the right who support the governing United Conservative Party more concerned about the economy and opening it up sooner, and those on the left more concerned about health and a slower reopening. 

There's also the at times confounding interplay of two core Alberta values. 

"One of the values is just that sense of individuality, that sense that I don't want government telling me what to do," says Brown.

"But another core value is a sense of community and coming together. Alberta can be sort of neighbourly like no other jurisdiction. So there's a funny push-pull there."

For Brown, it's a sign that despite the potential pushback against some policies, when it comes down to it, Albertans are prepared to clamp down and find solutions. 

Don't panic

Jenne says Alberta has been pretty lucky in terms of the timing of its infections and when most big policy decisions had to be made. School was out, winter was easing its grip and there were lessons to learn from other jurisdictions. 

At least two of those things will change in the coming months. 

"We have to remember that the overall spike we saw in April started with one individual in the province," he said. 

"So the fact that there's community level transmission is still a risk, and we don't exactly know — we've got good models and a good idea and we're prepared for it — but we don't know exactly what's gonna happen when school is open."

Jenne warns that it's up to individuals to remain vigilant and look out for one another or the province might have to reapply some of the restrictions that have fallen away. 

For Brown, the timing of a new round of anxiety over the numbers could actually prove useful.

"Maybe the fact that Albertans are getting agitated, that our numbers are going up, maybe that's the best thing that can happen," Brown said, "because we're going to go back to school with a level of vigilance that maybe people in Ontario aren't going to go back to school with."